Presentation Request Form

Please submit requests at least 8 weeks in advance. We are unable to accommodate any requests less than 8 weeks in advance.

We are not able to modify presentations, due to requirements for certification, restrictions on time and resources, or without risking the integrity of the presentation. Please take note of the time listed when requesting a presentation.

In Our Own Voice (60-90 minutes; for any audience) Creating Caring Communities in Minnesota: Five Things You Can Do (45-60 minutes; for any audience) Together We Can Make It Okay (45-60 minutes; for any audience) Faith Communities and People with Mental Illnesses (60 minutes; for faith-based communities) Children's Challenging Behaviors* (6 hours; for parents and families) Mental Health Crisis Planning (2 hours; for parents and families) Special Education Workshop (2 hours; for parents and families) Understanding Early Episode Psychosis (1.5-2 hours; for parents and families) Progression (6 weeks; for high school students with a diagnosis or symptoms) Recognizing Early Warning Signs of Mental Illness in Children and Adolescents (2-2.5 hours; for educators) Mental Health 101for African American Communities (1.5-2 hours) Means Restriction Education (60 minutes; for providers) safeTALK* (3 hours; for any adult audience) Question, Persuade, Refer - QPR (60 minutes; for any adult audience) Connect Postvention* (4 hours; for professionals and community leaders) Gray Matters: Understanding Mental Illness in Older Adults- multiple classes (1-2.5 hours, depending on class; for professionals working with older adults) Good Mental Health in the Workplace: Five Things You Can Do (60 minutes; for business leaders) Mental Health First Aid* (9 hours; for any adult audience) Youth Mental Health First Aid* (9 hours; for educators, youth caregivers, and families) Public Safety Mental Health First Aid* (9 hours; for law enforcement and first responders) Hope for Recovery* (6 hours; for families of individuals living with a mental illness) Smoking Cessation (1 hour; for any audience) Smoking Cessation for Providers (1 hour; for healthcare professionals) Applied Suicide Intervention Skills Training - ASIST (2 days; for any audience) Get to Know NAMI (1 hour; for any audience) Ending the Silence (50 minutes; for high school students)

NAMI Minnesota requests a $200 honorarium for many presentations with the understanding that not all organizations are able to provide this much, if anything. Certain classes do require a separate fee, and are denoted with *. Costs will be discussed during the scheduling process.

What amount of honorarium will you be able to provide?
*

Unable to provide any honorarium Not sure if able to provide an honorarium Will provide an honorarium, unsure of amount Will provide the full $200 honorarium N/A due to request class having a separate course fee

We require at least 8 weeks notice when scheduling presentations. If you request a presentation less than 8 weeks out, we will be unable to accommodate your request.

Specific date & start time
*

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Month
/
Day Year

Date

at

:
Hour Minutes

Confirm Day of Week
*

Are you requesting more than one presentation at the same location?
*

No Yes (Enter additional dates/times below)

Additional dates/times requested

Time length available for presentation
*

Organization name
*

Organization's website or brief description of organizations work
*

Address of organization:
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Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

Minnesota County (presentation location)
*

Will the presentation be held at the organization address?
*

Address of presentation (if different from organization address):

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

Contact Person
*

First Name Last Name

Phone (primary)
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-
Area Code Phone Number

Phone (other)

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Area Code Phone Number

E-mail
*

Are there any parking instructions or building information (room number for example) or other information that would help the presenters find the presentation location?